MSH Presents on the Role of Financing in Improving Access to Health Care

MSH Presents on the Role of Financing in Improving Access to Health Care at the 3rd Global Symposium on Health Systems Research in Cape Town, South Africa

On September 30 – October 3, 2014, nearly 3,000 researchers, program managers, and policy makers convened in Cape Town, South Africa for the 3rd Health Systems Research Symposium to review evidence and research focused on improving people-centered health systems and service delivery. A key component to strengthening health systems and improving health outcomes is through health care financing mechanisms. To explore this issue, three MSH staff members participated in a panel entitled the Role of Financing in improving access to health care: Experiences from Indonesia, Myanmar, Rwanda and other countries. Moderated by Michael Myers (Managing Director at the Rockefeller Foundation), the panel featured presentations from David Collins (MSH Senior Principal Technical Advisor – Health Care Financing), Uzaib Saya (MSH Senior Technical Officer -Health Care Financing), Dr. San San Aye (Director of the Department of Planning at the Ministry of Health, Republic of the Union of Myanmar), and Colin Gilmartin (MSH Technical Officer – Health Care Financing).

Presenting on the economic burden of tuberculosis in Indonesia, David Collins demonstrated how 25-year TB case projections can be used to advocate for long-term financing and investment into the health system. Despite increased external financing for TB case detection and treatment in Indonesia, there remains a significant gap in TB services for which the cost of inaction is high. Collins cited the high productivity loss and out-of-pocket spending associated with undetected cases and explained that TB treatment and prevention go hand-in-hand. “The more TB cases that can be treated, the more cases we can prevent.” According to Collins, assuming a TB case treatment rate of ~ 70%, a per capita $0.33 investment in medical costs for TB case detection and treatment can result in per capita $9 of savings to the health system and society as a result of improved productivity.

David Collins, MSH Senior Principal Technical Advisor - Health Care Financing, describes the projected financing required to effectively limit the gap in TB services in Indonesia.

David Collins, MSH Senior Principal Technical Advisor – Health Care Financing, describes the projected financing required to effectively limit the gap in TB services in Indonesia.

Presenting on the Government of Rwanda’s community-based health insurance (CBHI) social protection scheme, MSH’s Uzaib Saya cited preliminary research conducted in partnership with the Ministry of Health and the University of Rwanda’s School of Public Health. Findings showed that CBHI has afforded individuals lowered costs of health services and better access to medications. According to Saya, Rwanda’s CBHI scheme, which in 2013 initiated a sliding scale premium structure based on household-level income categories, increased financial protection to the poorest groups. Data from 1,300 households indicate that financial catastrophe was only observed in 0.38 percent of households and impoverishment rates as a result of out-of-pocket health payments have reduced considerably. Nevertheless, according to Saya, “these findings demonstrate that more efforts need to be undertaken to reduce the burden of inequalities related to out-of-pocket payments and CBHI premiums especially for poorer households.”

Uzaib Saya, MSH Senior Technical Officer – Health Care Financing, presents on the impact of Rwanda’s Community-Based Health Insurance (CBHI) Scheme.

Uzaib Saya, MSH Senior Technical Officer – Health Care Financing, presents on the impact of Rwanda’s Community-Based Health Insurance (CBHI) Scheme.

Recognizing the unique health challenges of Myanmar’s 330 townships, Dr. San San Aye presented on the importance of health planning at the township levels and financing in population health, and in achieving a pathway toward universal health coverage. According to Dr. San San Aye, while tax-based financing has increased government health expenditure in recent years, out-of-pocket payments must be reduced and social assistance programs must be increased at the township levels to ensure financial protection of Myanmar’s people.

San San Aye, Director of Planning at the Ministry of Health, Republic of the Union of Myanmar, presents on the unique challenges of Myanmar’s townships and financial investments required to achieve universal health coverage.

San San Aye, Director of Planning at the Ministry of Health, Republic of the Union of Myanmar, presents on the unique challenges of Myanmar’s townships and financial investments required to achieve universal health coverage.

Colin Gilmartin presented on the costs and cost-effectiveness of integrated community case management (iCCM) programs in seven countries in Sub-Saharan Africa. While iCCM programs are often considered to be a relatively cheap and low-cost intervention for treating childhood illnesses in hard-to-reach areas, results of MSH-led costing analyses  indicate that high program costs and low utilization can reduce the cost-effectiveness of such programs. According to Gilmartin, a comprehensive understanding of the costs and financing involved in iCCM programs allows countries, program managers, and policy makers to examine key cost-drivers (e.g. management, supervision, supply chain, and program overhead costs) and to advocate and plan for the efficient use of scarce resources. According to Gilmartin, “CHW programs and services must be well-utilized in order to be cost-effective.”

Colin Gilmartin, MSH Technical Officer - Health Care Financing, displays the pictures of three CHWs from Senegal, Cameroon, and Sierra Leone to illustrate the similarities of their job function but also how differences in their environments can affect the cost of community-based health services.

Colin Gilmartin, MSH Technical Officer – Health Care Financing, displays the pictures of three CHWs from Senegal, Cameroon, and Sierra Leone to illustrate the similarities of their job function but also how differences in their environments can affect the cost of community-based health services.

The four presentations highlighted experiences across countries and the impact of health financing strategies on improving access to health care.

Learn more about MSH’s role at the Health Systems Research Symposium and about MSH’s other activities related to Health Care Financing.

Links:

Celebrating African Health Leaders at the Global Symposium on Health Systems Research

Wednesday evening was spent celebrating the work and vision of African Leaders driving for stronger health systems and greater health outcomes in Sub-Saharan Africa. After a day of thought provoking sessions at the Global Symposium on Health Systems Research, Lord Nigel Crisp, Former Chief Executive of the UK’s National Health Service (NHS)  and Dr. Francis Omaswa, Executive Director of the African Centre for Global Health and Social Transformation (ACHEST), launched their new book, African Health Leaders: Making Change and Claiming the Future.

The book, with support from The Rockefeller Foundation, KPMG, and Oxford Press, is a collection of this of important stories and lives from 23 Sub-Saharan African health leaders and provides an inspiring vision for the future: African health leaders claiming their own future for their people and health systems; forging new relationships with international donors and partners to invest in growing deep roots into the soils, society and economies of traditionally low resourced countries.

In the past, as Omaswa asserts in Chapter 2, to improve their health systems, Africans went to institutions and countries for advice and money and got both.  But often this was in exchange for certain core values that in too many instances did not reinforce or acknowledge the traditional insights needed for the ownership and pride to sustain the solutions.

Her Excellency Dr. Nkosazana Dlamini-Zuma, Chairperson of the African Union Commission based in Ethiopia says it well in her dedication to the book: “As Africans we must celebrate improvements in health and the people who have made them happen, but we must also claim our own future for ourselves. Written by Africans, this book is essential reading for African health leaders who want to build on our own traditions and experience. It is also a vital orientation for partners who want to know how they can best support our efforts in a spirit of global solidarity.”

Three of the authors were present at the book launch to share their stories: Dr. Hannah Faal; Dr. Peter Eriki; and Dr. Ndwapi R. Ndwapi.

Dr. Hannah Faal was born in Nigeria and received a Fellowship to the Royal College of Surgeons in Edinburgh in 1975. She is respected for her pioneering work in The Gambia where she established the national eye care program that lead to The Right to Sight, a global initiative of WHO and the International Agency for the Prevention of Blindness, of which she became the President.

Dr. Peter Eriki attended the LMG Global Roundtable on Governance for Health in 2013 and is Director of Health Systems for ACHEST, a partner of ours supported by USAID to develop a “Ministerial Orientation Programme” that supports the capacity transfer for stronger health systems in Africa. Eriki has served as the WHO country representative for over 15 years in several priority African countries. He played a significant role in the revitalization of immunization programmes in Nigeria which had threatened to derail the global polio eradication effort. For this he received the Paul Harris Fellowship by Rotary International. He has his medical degree from Makarere University in Uganda and an MPH from Harvard.

Dr. Ndwapi R. Ndwapi is currently Manager of the Ministerial Strategy Office of the Ministry of Health in Botswana. Heralded as one of the “young leaders for health in Africa,” he has had responsibility as Director of Clinical Services with overseeing Botswana’s 26 public hospitals and more than 500 free-standing public outpatient clinics.

We can all learn from this collection of innovators and leaders about the knowledge, skills and attitudes it takes to address and master the many health challenges in Sub Saharan Africa. The launch was an inspiring evening with real change-makers from health systems in Africa.

Photo Credit: ACHEST. From Left: Lord Nigel Crisp, Prof. Francis Omaswa, Hon. Ruhakana Rugunda, Susan Edjang, Prof. Miriam Were, and Hon. Okello Oryem

Strengthening Health Systems Journal Publishes MSH Editorial

Sometimes the people who know best are, well, the people. Achieving the fundamental objectives of UHC and meeting the challenges of governing complex health systems requires people-centered schemes that include formal mechanisms to bring civil society and communities into the design and implementation of UHC programmes.

In its second issue, The Strengthening Health Systems journal has published an MSH editorial titled, “People-centered health systems for UHC: How to put people first while increasing health service access.” Written by MSH CEO Jonathan Quick, Senior Writer Jonathan Jay, and Research & Communications Specialist Chelsey Canavan, this editorial discusses a people-centered approach to UHC, highlighting three areas where civil society and communities play vital roles: ensuring the right services are provided under an essential package of health services, removing barriers to care such as user fees, and ensuring equitable access to health services.

In each of these areas and at every level of the health system, citizen representation is essential. Bringing communities into the process at every step in the design and implementation of UHC will help ensure meaningful increases in equity and improvements in health outcomes for the people the health system is meant to serve.

A PDF download is available and more information about the latest issue is available on the Strengthening Health Systems website.

 

Governance and Health in Africa: Voices from the Opening Plenary

The Third Global Symposium on Health Systems Research is being held this week in Cape Town, South Africa with the theme “Science and Practice of People-Centered Health Centers.” The conference is holding over 100 plenary sessions, film conversations, posters, book launches, and interactive panels. It kicked off this evening with the opening plenary, Governance and Health in Africa: Pan-African perspectives on state stewardship for people’s health. Below is commentary from the opening panelists on how governance impacts health systems and the ability of people to claim their right to health.

Lucy Gilson, Co-chair, South Africa Local Organizing Consortium:

“Health systems are part of the fabric of the society of which we live. And health systems are always political. The reflection and debate of this symposium must be the basis for taking action on health decisions and social justice for all.”

Sisonke Msimang: South African Writer and Activist

“What does power, democracy, and rights have to do with the mundane bureaucratic business of delivering health?A state saying that it’s people has a right to health has great implications for how that state plans and budgets.”

Thandika Mkandawire, Professor of African Development, London School of Economics

“Health is an important social policy. People think of the protective role social policy plays. But we need to take into account the productive and informative role of social policy, especially  when it comes to health.”

Mahaman Tidjani Alou: Dean, Faculty of Economics and Law, Universite Abdou Moumoini, Niger

“Economic growth doesn’t necessarily bring access to medicines and health care to people equally. Inclusion is not guaranteed. There is a paradigm of unequal growt, but democracy can trigger inclusiveness in decision making which makes decisions more representative.”

Belgacem Sabri, Chair, Association for Defending the Right to Health, Tunisa

“Many can pay for private sector health care, but the vulnerable are left to a failing public system. There is an erosion of the right to health, which contributed to the uprisings that have happened in Tunisa. We hope to move towards better participation and people-centered decisions.”

Photo Blog: Day 2 of the Global Governance for Health Roundtable

From September 29th – 30th, over 50 thought leaders in global health are gathering in Cape Town, South Africa for the Third Global Governance for Health Roundtable. The Leadership, Management & Governance (LMG) Project is collaborating on the Roundtable with the Health Policy Project and the Health Finance and Governance Project.
On the second day of the Roundtable, conversations focused on donor investments in good governance and how to further support vulnerable populations and national civil society organizations in governance interventions.

Day 2 began with remarks from Dr. Tomohiko Sugishita (left) of the Japanese International Cooperation Agency on the panel, Investing in Good Governance as an Enabler for Health Systems Strengtheningwhich included Temitayo Ifafore, of the United States Agency for International Aid.

Robert Ndieka, a Monitoring and Evaluation Expert at the African Union Commission, observes discussions at the Global Governance for Health Roundtable.

Jan Sobieraj (center), Managing Director of the UK’s National Health Service Leadership Academy, acted as a rappateur for the roundtable along with Barry Kistnasamy of South Africa’s Department of Health (left).

LMG Director, Jim Rice, gives closing remarks at the Third Global Governance for Health Roundtable.

MSH will host Universal Health Coverage Conference in Cape Town prior to Symposium

The post also appears on the SIAPS Program blog.

From September 28 to 30, 2014, global experts will convene in Cape Town, South Africa, in an invitation-only meeting organized by Management Sciences for Health (MSH) with funding from SIAPS to start a dialogue on medicines and universal health coverage (UHC). At last year’s meeting, it became clear that many national UHC plans do not give priority to medicines management. The meeting in Cape Town will focus on managing medicines in the context of UHC rollout. The meeting objectives are:

  • Sharing successful and unsuccessful experiences in how countries have incorporated medicines into their UHC strategies
  • Creating a shared understanding on how sound medicines benefits design and management can contribute to cost control
  • Building a case for use of evidence-based decision making in medicines benefits design and management
  • Sharing the pilot experiences of Namibia and South Africa as they implemented a new tool on medicines benefits management

For more information about this meeting and other UHC issues, please visit  www.uhc-medicines.org

 

Making Political Will Work for Health Systems

This post, written by Taylor Williamson and Derick Brinkerhoff, Health Policy Project, RTI International, originally appeared on the LMG For Health Project blog.

The Third Global Governance for Health Roundtable will be held in Cape Town, South Africa September 29-30th prior the the Third Global Symposium on Health Systems Research. The Leadership, Management & Governance (LMG) Project is collaborating on the Roundtable with the Health Policy Project and the Health Finance and Governance Project

Maternity care is free in Kenyan hospitals.Nearly 91% of Rwanda’s population is enrolled in a health insurance scheme. There are 2.4 million people on antiretroviral therapy in South Africa. What links these well-known examples of health system successes? Strong political will to improve health in these countries.

Commissioner of the Commission on Human Rights, Lauretta Vivian Lamptey, and Administrative Justice and the Director General of the Ghana AIDS Commission, Dr. Angela El-Adas, launch a partnership to protect the human rights of PLHIV and key populations. Photo Credit: Health Policy Project

Commissioner of the Commission on Human Rights, Lauretta Vivian Lamptey, and Administrative Justice and the Director General of the Ghana AIDS Commission, Dr. Angela El-Adas, launch a partnership to protect the human rights of PLHIV and key populations. Photo Credit: Health Policy Project

Political will is often only discussed in terms of its absence. How often have health systems experts heard that reform efforts were not achieved due to changes in the Ministry of Health, or that reform momentum ceased when donor funding ended?

Focusing on implementation failures reduces the concept of political will to the willingness and capacity of country officials to take responsibility for donor-funded programs.  For example, country officials are often willing to have donors fund programs, but balk at implementing complicated reforms or including donor priorities in national budgets.
The strength of a health system, however, depends on what country actors are willing and able to do, not just what donors will fund. To incorporate the perspectives of these country actors into the concept of political will, the USAID-funded Health Policy Project proposes a different approach to thinking about political will.

Reframing political will as the commitment of health system actors to act on policy objectives and sustain the costs of those actions over time can move country officials to the forefront of reform efforts. This approach places the responsibility of driving the reform process on country officials, who must formulate policy, implement programs that achieve their objectives, fund budgets to implement programs, and monitor program outcomes. Even when donor funding is available, political will requires the leadership of country officials to fulfill these roles.

Policymakers, implementers, and citizens are faced with the following questions that can inform the efforts of health systems experts to understand political will:

  • Where does the power to enact reforms rest? Are the willingness and capacity of individual decisionmakers, specific institutions, and/or a broader network of stakeholders taken into account?
  • What are the intentions of various health sector actors?  What motivates them to improve health systems? Can we infer that political will exists by observing budget allocations or public speeches?
  • Finally, what is the impact of civil society advocates? The media? Health providers? What about government structures and processes? Local variations in these influences can significantly affect the politics of health reform.

Based on these considerations, Derick Brinkerhoff, RTI International Distinguished Fellow in International Public Management, developed a model of political will that highlights seven components:

  1. Government initiative for policies and programs
  2. Choice of policies and programs based on scientific evidence and technically sound options
  3. Mobilization of stakeholders
  4. Public commitment and allocation of resources
  5. Design and application of credible incentives
  6. Continuity of effort
  7. Learning and adaptation

These components can be rated on a sliding scale to capture degrees of political will, from weak to strong.  They can also help health systems practitioners gain a greater appreciation for the political environment that supports health to improve their work identifying gaps and recommending reforms.

Reconsidering the “implementation failure” approach and applying a more rigorous analytical framework to political will can move health systems much closer to the goal of strengthening health systems for the long run, an aim shared by country officials, their citizens, and the international community.

LMG to host Third Global Governance for Health Roundtable

Good governance is essential to strengthening health systems and has the ability to greatly impact health services utilization and health outcomes. The Leadership, Management & Governance (LMG) Project is hosting the Third Global Governance for Health Roundtable to bring together thought leaders from across the world to explore trends and practices for good governance within the health sectors of low- and middle-income countries.

Photo Credit: Todd Shapera, 2013

Photo Credit: Todd Shapera, 2013

The two day event, held in Cape Town, South Africa, is organized in collaboration with the Health Finance and Governance (HFG) Project, and the Health Policy Project (HPP), and will address the following six themes:

  • Generating Evidence for Action: Measuring the impact of governance
  • Advancing health equity and access to health services through good governance
  • Inclusive Governance: Meaningful engagement of women and traditionally marginalized populations
  • Politics, policy, and effective governance for health
  • Governing in Decentralized Health Systems: Case studies from the field
  • Donors: Investing in good governance for health

The insights from the invite-only roundtable will be reported out at the Third Global Symposium on Health Systems Research at the Cape Town International Conference Centre. Please join us on Wednesday, October 1st from 4:30 – 6:00pm (room 1.63-1.64) in the session titled, “Governance that enables evidence for stronger health systems and greater health outcomes,” Dr. James Rice, Project Director, Leadership, Management & Governance, will moderate the session discussing:

  • breaking through the challenge of measuring the impact of good governance
  • the power of effective women engagement in modern governance arrangements for health services delivery and finance in the journey to UHC and equity
  • lessons about governance practices that unleash more significant and more sustainable health services research for health systems performance

Attending the Third Global Symposium on Health Systems Research? Check out the full schedule of LMG events or follow live updates on Twitter and Facebook.

Proceedings from the previous two Global Governance for Health Roundtables are available here. For more information, please contact Sarah Lindsay:slindsay@msh.org

Leadership, Management & Governance Project to share research at the Third Global Symposium on Health Systems Research

Join the Leadership, Management & Governance (LMG) Project at the Third Global Symposium on Health Systems Research in Cape Town, South Africa from September 30th – October 3rd. LMG will be participating in multiple sessions throughout the week to share research and results on the impact of governance on health systems. If you can’t make it to the sessions in person, follow them Twitter and Facebook for live updates from Cape Town.

Photo Credit: Mark Tuschman, Kenya, 2014

Photo Credit: Mark Tuschman, Kenya, 2014

Monday, September 29th
Satellite Session: Translation Science: Lessons learned in health system strengthening from PEPFAR
10h30-14h00
Room 2.65, Cape Town International Convention Centre
PEPFAR will offer two separate panels to explore translation science: lessons learned in health systems strengthening.
Panel One: PEPFAR contributions to health systems research and lessons learned, will focus on findings from PEPFAR that may be applicable beyond the HIV epidemic, with a focus on service delivery, finance and human resources for health. Presentations will include research from four PEPFAR implementing agencies.
  • Alexandra Zuber, Centers for Disease Control and Prevention, USA (moderator)
  • Karen Cavanaugh, United States Agency for International Development, USA
  • Lyn Middleton, Health Resources and Services Administration, USA
Panel Two: Innovative metrics for capacity-building and country-led programming, will highlight innovative metrics to quantify and measure capacity in the HIV/AIDS response. Presentations will include important health systems metrics work conducted by PEPFAR and the Global Fund.
  • Mai Hijazi, United States Agency for International Development, USA (moderator)
  • Eric Sarriot, ICF International, USA
  • Dr. Reshma Trasi, Leadership, Management & Governance Project, Management Sciences for Health 
  • George Shakarishvili, Global Fund to Fight AIDS, TB and Malaria
Satellite Session: Fostering Change for  Scale-up of Effective Sexual and Reproductive Health Services
9h00-17h00
Room 1.41, Cape Town International Convention Centre
Everyone working to improve health, at all levels, is in the business of fostering or implementing change. The session is for health professionals who want to bring about widespread, lasting change in their countries—health professionals who want to move beyond the myriad of promising pilot projects to building stronger, more effective health systems.  The Guide to Fostering Change to Scale Up Effective Health Services provides a systematic ‘how-to’ process for introducing and scaling up innovations in health. The Guide serves as a ‘missing link’ to assist countries in systematically identifying effective practices, planning and implementing their scale-up, to make the kind of impact that we know you want to make in your respective health systems.
Join us to learn proven practices to help lead change efforts, identify and describe key components to scaling up, hear experiences in scaling up reproductive health practices and programs—including scaling up youth-friendly family planning services in Zimbabwe—and practice applying these methodologies to specific scaling-up processes. Participants will leave the workshop with new resources, tools and actionable steps they can take to support scale-up efforts in their particular contexts.
Panelists are:
  • Suzanne Reier, Public Health Advisor, WHO, Geneva (moderator)
  • Odongo Odiyo, East, Central, and Southern Africa (ECSA) Health Community
  • Cynthia Chasokela, Director, Nursing and Midwifery Services, Ministry of Health and Child Care, Zimbabwe
  • Kate Wilson, Technical Advisor, Leadership, Management & Governance Project, Management Sciences for Health, USA
  • Nandita Thatte, Technical Advisor, USAID, USA
Wednesday, October 1st
Concurrent Session: Governance that enables evidence for stronger health systems and greater health outcomes
16h30 – 18h00
Room 1.63-1.64, Cape Town International Convention Centre
This session will discuss the value of good governance to create conditions in which health services research is more likely to flourish and yield stronger health system performance. The session will report results from the Third Global Governance for Health Roundtable that took place prior to the Symposium and discuss:
  • Breaking through the challenge of measuring the impact of good governance
  • The power of effective women engagement in modern governance arrangements for health services delivery and finance in the journey to UHC and equity
  • Lessons about governance practices that unleash more significant and more sustainable health services research for health systems performance
Panelists are:
  • Dr. James Rice, Leadership, Management & Governance Project, Management Sciences for Health
  • Dr. Reshma Trasi, Leadership, Management & Governance Project Management Sciences for Health
  • Dr. Ayanda Ntsaluba, Former Director General Health South Africa and Board Member, Discovery Health (TBC)
  • Taylor Williamson, Health Policy Project and RTI International
Thursday, October 2nd
Oral Presentation: People-centered health systems and Corruption: A global survey of health managers’ perceptions of the causes of, and recommended ways to reduce, health sector corruption
16h30-18h00
Roof Terrace, Cape Town International Convention Centre
Presenter: Meghan Guida, Leadership, Management & Governance Project, Management Sciences for Health
Corruption adversely affects access to healthcare worldwide, especially in countries with poor governance, low transparency, and weak accountability.  The factors that encourage corrupt practices in health systems affect both the health workforce and patients. This session will discuss ways to mitigate these factors and the results of a July, 2013 online survey of health managers and leaders across 95 countries to assess perceptions of corruption in the health sector.
Learning Objectives:
  • Identify causes of corruption in the health sector, and ways to mitigate corruption.
  • Articulate how the health workforce and clients’ needs and rights overlap and are affected by corruption in the health sector.
  • Formulate ways in which stakeholders (governments, donors, practitioners, etc.) could empower communities to address corruption in the health sector.
Friday, October 3rd
Poster Presentation: Corruption in the health sector: An analysis of health leaders’ and managers’ perceptions on corruption by age
Authors:
  • Dr. Reshma Trasi, Leadership, Management & Governance Project, Management Sciences for Health
  • Mariah Boyd-Boffa, Management Sciences for Health
  • Angela Lee, Management Sciences for Health
Corruption erodes health services quality and access, particularly in low- and middle-income countries. This poster presentation will present the results from a survey hosted on statpac.com in July 2013 that queried health managers and leaders on factors contributing to health sector corruption, and the effectiveness of interventions on reducing corruption. Of particular interest is the finding of a difference between younger and older respondents’ views on the importance of societal acceptance of corruption as normal, and views in the lack of ethical or moral integrity among health workers.

How to Join the Symposium from Outside Cape Town

This post is cross-posted from the Third Global Symposium website.

Unable to make it to Cape Town? Follow the conference online!

The Symposium organizers encourage you to post comments or suggestions via Health Systems Global’s Twitter, Facebook or LinkedIn profiles.

Or contribute a blog or comment on one: http://www.healthsystemsglobal.org/GetInvolved/Blog.aspx

Or tweet a comment addressing one of the plenary themes for panels to consider:

And of course watch the plenaries live – or recorded, when you have time – via the Symposium website http://hsr2014.healthsystemsresearch.org/ .